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When Is the Evidence Sufficient?

Robert H. Fletcher, MD, MSc

JAMA. 1993;270(8):987-988.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

For years there have been dreams of a simple test that could detect cancer in its early stages, before it had caused symptoms, when it could be treated to better effect. This dream has been reinvigorated, then dissipated, repeatedly in recent years. Each new test has in turn been announced with enthusiasm, then studied more carefully in a broader spectrum of patients and found to have at best only a small place in the management of cancer.

Nevertheless, it remains likely that someday there will be a truly useful blood test for cancer. Has that day now come?

In this issue, Moertel and colleagues¹ describe the effectiveness of one such test, carcinoembryonic antigen (CEA), when it is used to detect recurrence after colon cancer surgery. Carcinoembryonic antigen, which is present in blood during fetal life, falls to very low levels in most adults, and circulates in high concentrations in . . . [Full Text PDF of this Article]

Footnotes
Dr Fletcher is co-editor of the Annals of Internal Medicine

The views expressed herein are those of the author and do not necessarily reflect the views of the American College of Physicians.

Reprint requests to Publication Division, American College of Physicians, Sixth at Race Street, Philadelphia, PA 19106-1572 (Dr Fletcher).

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